
At least half of all parents tried over shaken baby
syndrome have been wrongly convicted, expert warns
By ANGELA LEVIN
Last updated at 6:13 PM on 1st May 2011
It is a case that haunts Dr Waney Squier and one any parent will find
deeply distressing.
Eleven
years ago, Lorraine Harris stood trial at Nottingham
Crown Court charged with manslaughter. Although described as a woman of
good character and a careful and caring mother, she was accused of
shaking her four-month-old baby Patrick to death two years earlier.
Neuropathologist Dr Squier wrote a report for the prosecution saying
that the child was the victim of shaken baby syndrome (SBS).
Lorraine, who vehemently protested her innocence, was convicted and
jailed for three years.
Her punishment was not limited to incarceration, as tragic consequences
rippled out from Patrick’s death. Lorraine wasn’t allowed to go to his
funeral; a baby she gave birth to as she was starting her sentence was
taken away for adoption; her partner left her and both her parents died
while she was in prison. Her life fell apart.
By the time Lorraine’s appeal was heard in 2005, Dr Squier had become
convinced the criteria she had used to define whether SBS had taken
place were wrong. In a complete U-turn, she now appeared as an expert
witness for the defence. Lorraine’s conviction was quashed.
It is difficult to imagine Lorraine’s feelings as she digested this
news. Relief, perhaps, but the occasion could hardly be described as
joyous. One of her children had died and she had not been allowed to
grieve. Another child had been taken from her. And she would possibly
never be free from the taint of the original conviction.
‘Her conviction was overturned but it was a hollow victory because her
life had been completely devastated,’ says Dr Squier, who had helped
right a wrong but could not erase the pain it had caused.
‘I did and sometimes still do feel terrible about what happened.
‘I now believe that half or even more of those who have been brought to
trial in the past for SBS have been wrongly convicted. It is a
frightening thought.’
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Lorraine Harris
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It is indeed, and it is an extraordinary claim but one that should be
taken seriously. Dr Squier, 63, is the most experienced paediatric
neuropathologist in the country. She has spent 30 years researching
baby brains and has a solid international reputation.
She has appeared countless times in court as an expert witness in cases
of SBS, when a child is said to have been shaken so violently that it
results in brain injury or death.
You would imagine that when such an eminent scientist says recent
scientific developments show that, in the past, she and others have
been wrong about SBS, she would be listened to.

Dr. Waney-Squier
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Instead
Dr Squier has been on the receiving end of vicious
attacks by some doctors, lawyers and police officers who do not like
her views. She has even been referred to as a supporter of child
abusers.
‘Why would I want to do that?’ she asks.
‘I have children of my own. I am chilled by the thought of getting it
wrong because of the risk of sending babies back to abusive households,
or taking them away from families, or putting people in prison.’
About 250 SBS cases go to court each year. Expert witnesses play a
pivotal role in trials. Babies often do not have any symptoms other
than bleeding to the head and eyes so, unlike most criminal cases, the
opinion of the pathologist may be the only evidence to consider.
However, some convictions are controversial. The problem has been that
there is no single agreed definition of SBS. Instead, for the past 30
years, the findings of a U.S. radiologist, John Caffey, have been used
in courts.
These findings centre on three signs – swelling of the brain, bleeding
between the skull and the brain, and bleeding in the retina – known
collectively as the triad. If they are present then a conviction is
likely.
But Dr Squier is one of a growing number of
doctors who believe that relying on the triad alone is no longer enough.
‘Over the past ten years so much more has
been discovered about
how a baby’s brain develops in its first year and these developments
have seriously undermined SBS,’ she explains.
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‘We now know, for example, that almost half of babies have a triad at
birth, which can be caused by different factors.
‘In the past four years there have been several discoveries about the
dura, the membrane covering the brain. It was thought that it was there
to protect the brain from shock, but we now know it also has the very
important function of controlling blood flow out of the brain.
‘At birth the dura has huge blood channels that can leak – and not
always as a result of trauma. They do, however, disappear during the
child’s second year of life.
‘These findings are so significant that I now believe that half or even
more of those who have been brought to trial in the past for SBS have
been wrongly convicted.
'I am also convinced we can virtually exclude shaking as a cause of
death in babies unless, as well as bleeding in the brain, we have
additional evidence of trauma, such as serious damage to the neck.
‘When a baby is shaken, the head will flop back and forth and the neck
becomes the weak point. In other words, if you shake a baby so hard
that it dies, it is the neck that is going to show the damage, not the
brain.’
Although her view is gathering momentum worldwide, it has ignited an
increasingly toxic argument between doctors, lawyers and police.
‘Some pathologists want to remain in an unchallenging comfort zone of
an outdated theory,’ Dr Squier explains.
‘Some judges don’t like the fact that new scientific discoveries make
convictions more complex, and the police don’t like them because it can
prevent them from getting the convictions they want.
‘I think the police are so put-out that they are trying to ban me from
court. It’s why I would like Justice Secretary Kenneth Clarke to set up
an inquiry into the methods police have used to deter expert witnesses
who challenge old mainstream beliefs.
'This raises serious concerns that one side of the argument is not
being heard and means there cannot be a fair trial.
‘If I am blocked from giving evidence in court, defendants already
having to cope with the tragic death of a baby will not get the benefit
of the new science. Equally, if the courts fail to accept that the
mainstream view of 30 years ago can no longer be relied upon, there
will be serious miscarriages of justice.’
Dr Squier, who is divorced with two grown-up daughters, is devoted to
her work and, despite the pressure she is under, she speaks calmly.
Born in Surrey, she qualified as a doctor at Leeds Medical School.
After spells in Bristol, Cornwall and London, she moved to Oxford in
1984 and took up a post as consultant pathologist at the John Radcliffe
Hospital, where we talked.
‘Once I came here I specialised in baby brains,’ she explains. ‘I have
looked at thousands and written more than 100 medical papers on normal
brain development and what happens when things go wrong both in
pregnancy and after birth. In the past 15 years, I have investigated
many unexpected deaths.’
Her change of opinion was triggered ten years ago by pioneering work
carried out by Jennian Geddes, a former consultant neuropathologist at
the Royal London Hospital.
Geddes argued that, in a small number of cases, injuries associated
with the triad can occur naturally; that some babies suffer from a lack
of oxygen supply that triggers bleeding; and that there should be some
signs that the baby suffered trauma.
‘A light went on in my head,’ Dr Squier says.
‘I became concerned that the whole basis for shaking was poor.’
She began to conduct her own investigations and found similar evidence
to Geddes.
‘It made me feel guilty about my previous unquestioning acceptance of
the shaking hypothesis.
‘All my cases are now based on a newer understanding of the science. I
am happy with rigorous debate but take exception to attacks on my
integrity and professionalism. It is intellectual laziness to apply the
old triad diagnosis when symptoms can be explained by natural causes.’
Dr Squier has an impeccable professional reputation so she was shocked
early last year to receive a letter from the Human Tissue Authority, an
organisation which ensures that doctors keep good records and have
consent for everything they do.
‘The Metropolitan Police had raised concerns about the way I was
handling post-mortem tissue and the possibility that unrecorded
material was being stored, used and disposed of without the knowledge
of the police. Fortunately, our procedures at John Radcliffe are
absolutely robust, we know where every piece of tissue is, and no
action was taken.
‘Then last June, I heard that a complaint on the same subject had been
lodged against me with the General Medical Council.’
Dr Squier had to face an interim orders panel, which was set up after
the conviction of Harold Shipman to protect the public and the
profession from dangerous doctors. Her appearance was requested by the
National Policing Improvement Agency and Detective Inspector Colin
Welsh, lead investigator at Scotland Yard’s child abuse investigation
command.
‘I barely slept for six weeks,’ she says.
‘It was a terrible experience but the hearing had barely got under way
when it was dismissed and no restrictions were made on my practice.
‘However, the panel couldn’t remove the complaint lodged about me with
the GMC and I don’t know whether it will take it forward. It is hanging
over me like a dark cloud.
'I know the GMC will not approve of me speaking out but too much is at
stake for me to stay silent.’
The accusations began to make sense following a conference on shaken
babies, which took place in Atlanta, Georgia, last September.
DI Welsh, in a public lecture, talked disparagingly about prosecution
cases that had failed largely due to expert defence witnesses.
He described a way of eliminating them from criminal and possibly
family court trials, thus precluding alternative views being presented.
He believed they confused the jury and possibly the judges with the
complexity of science.
DI Welsh’s solutions included ‘questioning everything – qualifications,
employment history, testimony, research papers presented by these
experts, go to their bodies to see if we can turn up anything’.
Among the audience was lawyer Heather Kirkwood, who was so shocked that
she took notes and has signed an affidavit that these notes are a true
record.
She says: ‘In the past decade, we have learned that much of what we
thought we knew about SBS was wrong, and that many of the babies that
we thought were shaken were instead suffering from birth injuries,
childhood stroke, or metabolic or infectious disease.
‘Now that we know we got it wrong, we need to get it right. Instead,
many prominent advocates of shaken baby theory have resorted to
attacking researchers such as Dr Squier, who is one of the world’s
leading experts on the infant brain.
‘Families and children deserve better. To get it right, we need open,
honest debate, not cover-ups or attacks on those identifying the
problems and seeking solutions.’
Dr Squier was outraged to learn of DI Welsh’s comments.
‘It proved in my mind that the police have set out to remove me and two
other neuropathologists who share the same view from the courts because
we have stood in the way of their campaign to improve conviction rates.
If an expert witness bases an opinion on reasonable scientific ground,
even if the opinion is a minority one, it should not be excluded.
‘I am determined not to be silenced and if I can’t speak out in court,
I shall do it in scientific papers. It cannot be fair to gag one body
of opinion. The whole thing is a nightmare, not least because instead
of researching vital things about babies, I have to spend time trying
to clear my name.
‘Meanwhile, the number of court cases I have been asked to attend has
plummeted from 30 a year a few years ago to five in the past year.
‘Some lawyers are still willing to instruct me because they believe I
will give them an opinion based on the science. Others feel they can’t
use me while the complaint is hanging over me.
‘The experience has made me feel like a whistleblower – on the one hand
challenging all those who prefer the comfort of old mainstream opinion,
and on the other struggling for my professional life.’
DI Welsh was unavailable for comment, but Scotland Yard said in a
statement: ‘The Metropolitan Police did register concerns about certain
practices of a doctor with the Human Tissue Authority in December 2009.
The Metropolitan Police also agreed to provide any relevant information
to the GMC following a report registered by the National Policing
Improvement Agency with the GMC.’
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